Download Traumatic Brain Injury

Oral Health Fact Sheet for Medical Professionals
Children with Traumatic Brain Injury
Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden trauma causes damage
to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the
skull and enters brain tissue. Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of
the damage to the brain. (National Institute of Neurological Disorders and Stroke/NIH)
Oral Manifestations and Considerations
Oral
• Oral/dental trauma from TBI or self-injurious behaviors
• Bruxism
• GERD
• Inadequate oral hygiene due to cognitive impairments, spasticity and ataxia
Other Potential Disorders/Concerns
• Seizures
• Depression/Anxiety
• Post-traumatic stress disorder
• Personality disorders
• Substance abuse
Oral Side Effects of Commonly Prescribed Medications
Medication: Manifestations from TBI vary; therefore a range of medications may be prescribed:
SYMPTOM
MEDICATION
SIDE EFFECTS
Muscle Relaxants
Xerostomia
Repetitive Behaviors
Antidepressants
Xerostomia, dysgeusia, stomatitis,
gingivitis, glossitis, sialadenitis, bruxism,
dysphagia, discolored tongue, oral edema
Aggressive Behaviors
A. Anticonvulsants (Dilantin)
A. Gingival hyperplasia, xerostomia, stomatitis,
glossitis, dysgeusia
B. Antipsychotics
B. Xerostomia, sialorrhea, dysphagia, dysgeusia, stomatitis, gingivitis, tongue edema, glossitis, discolored tongue
Hyperactivity
A. Antihypertensive
A. Xerostomia, dysphagia, sialadenitis, dysgeusia
B. CNS Stimulant
B. Xerostomia
Children with Traumatic Brain Injury continued
Parent/Caregiver Support and Guidance
• Discourage consumption of cariogenic foods and beverages.
• Prescribe sugar-free medications, if available.
• Recommend preventive measures, such as topical fluoride and sealants.
• Advise the use of fluoridated toothpaste twice daily and support the family in following dental care
instructions.
• Instruct caregiver on appropriate protocol following dental trauma (locate/preserve missing tooth and put
in cold milk; seek immediate professional care).
• Review safety issues appropriate to the age of the child, such as mouth guards to prevent oral-facial trauma.
• Discuss habits that may harm the child’s teeth, such as propping baby bottles, putting child to bed with bottle.
• Refer to dentist any oral developmental abnormalities.
Additional information: Special Needs Fact Sheets for Providers and Caregivers
References
• Taylor, HG., Yeates, KO., Wade, SL., Drotar, D., Stancin, T., Minich, N. (2002) A prospective study of
short- and long-term outcomes after traumatic brain injury in children: behaviour and achievement.
Neuropsychology, 16: 15–27.
• McKinlay, A., Grace, R.C., Horwood, L.J., Fergusson, D.M., Ridder, E.M., MacFarlane, M. (2008) Prevalence
of traumatic brain injury among children, adolescents and young adults: Prospective evidence from a birth
cohort. Brain Injury, 22(2): 175-81.
Additional Resources
• NIH Institute for Traumatic Brain Injury
• Special Care: an Oral Health Professionals Guide to Serving Young Children with Special Health Care Needs
• Bright Futures Oral Health Pocket Guide
• American Academy of Pediatrics Oral Health Initiative
• American Academy of Pediatric Dentistry: 2011–2012 Definitions, Oral Health Policies and Clinical
Guidelines
• MCH Resource Center
• ASTDD-Special Needs
• Block Oral Disease, MA
• NOHIC-NIDCR publications
DOH 160-068 March 2012
Permission is given to reproduce this fact sheet.
Oral Health Fact Sheets for Patients with Special
Needs © 2010 by University of Washington and
Washington State Oral Health Program
Fact sheets developed by the University of Washington DECOD
(Dental Education in the Care of Persons with Disabilities) Program
through funding provided to the Washington State Department of
Health Oral Health Program by HRSA grant #H47MC08598).
For persons with disabilities, this document
is available on request in other formats.
To submit a request, please call
1-800-525-0127 (TTY/TDD 1-800-833-6388).